Provider Demographics
NPI:1952987026
Name:WIMBUSH, TOMEIKA MICHELLE
Entity type:Individual
Prefix:DR
First Name:TOMEIKA
Middle Name:MICHELLE
Last Name:WIMBUSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TOMEIKA
Other - Middle Name:MICHELLE
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2806 HILLCREEK DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6484
Mailing Address - Country:US
Mailing Address - Phone:706-863-0200
Mailing Address - Fax:706-863-4695
Practice Address - Street 1:2806 HILLCREEK DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6484
Practice Address - Country:US
Practice Address - Phone:706-863-0200
Practice Address - Fax:706-863-4695
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168615163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory